OBJECTIVES: To evaluate the potential clinical and economic outcomes of using genotype data to guide the management of warfarin anticoagulation therapy. METHODS: A decision tree was designed to simulate two groups – group of standard care and genotyped group. Both groups were separated by CYP2C9 genotypes in patients with alleles CYP2C9*2 and CYP2C9*3 and patients with genotype CYP2C9*1*1. CYP2C9*1*1 patients were subdivided further into VKORCBB and VKORCAA/AB types. Outcomes in each group were: major bleeding (gastrointestinal and intracranial), minor bleeding (hemorrhoid, hemarthrosis, hemophtalmos and others) and no bleeding. Direct medical costs from the Russian healthcare system point of view were estimated. Rate of bleedings in patients with different genotypes and relative risks of bleedings in pharmacogenetic-oriented approach were obtained from the literature.  Sensitivity analysis to key parameters was performed. RESULTS: In the basic scenario costs of the standard treatment were higher than in pharmacogenetics-oriented group: 8545 rubles (USD305) and 6806 rubles (USD243) for 1 patient per year respectively. Sensitivity analysis showed that the model is sensitive to the price of pharmacogenetic test only: the pharmacogenetic approach remains cost-saving until the test costs less than 2600 rubles (USD93). CONCLUSIONS: In the Russian health care system, pharmacogenetic-oriented warfarin therapy is cost saving if the price of pharmacogenetic test does not exceed 2600 rubles (USD93).